Which is better an ileostomy or a colostomy--if given a choice?

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Regular Member

Date Joined Aug 2007
Total Posts : 76
   Posted 9/13/2007 7:11 AM (GMT -6)   
Still contiplating the surgery but does anyone have any idea which is better to have? I have an option and am not sure. Is one bag lower than the other? Bigger than the other? I know a colostomy is permanent and ileostomy can be reversed. Much difference? Any preference?
30 yr. old dx with CD 10 years ago. Currently on folic acid and azulfadine.  Had ileum removed and resection May 2007.  Just started back to work after being off 13 weeks.  Still feeling lousy.  In the process of trying to get approved to start Humira ASAP!!!!  It scares me immensely!!!!  Just started Humira 8/20/07-loading dose of 4 pens (160mg).
Allergic to: Asacol, Pentasa, Imuran, Paxil, Zoloft, Penicilian, Ampicilian
And prednisone does not work for me anymore!!!

Veteran Member

Date Joined Feb 2003
Total Posts : 1251
   Posted 9/13/2007 8:33 AM (GMT -6)   
Both ileostomies and colostomies can either be permanent or reversible. An ileostomy stoma is usually on the right side of the abdomen whereas a colostomy is on the left. An ileostomy stoma is made from the small intestine and the colostomy is made from the large, therefore an ileostomy stoma is usually a bit smaller.

The biggest difference is that ileostomy output will vary from watery to a paste like consistency whereas, depending on whereabouts in the large intestine the colostomy stoma is put, output can range from solid to pasty (the higher up in the intestine the stoma is, the less solid output will be as there is less intestine left to absorb water). Ileostomates, therefore, typically wear drainable bags (where you just drain the stool from the bag into the loo) whereas colostomates usually wear closed end bags (ie they just take the old bag off and dispose of it and put a new one on).

Many people with a colostomy of the sigmoid or descending colon can irrigate whereas ileostomates can't. Irrigation means giving yourself a water enema every 24 - 48 hours which returns all the stool at once leaving you stool free until the next irrigation. This means that you probably won't have to wear a bag, just a piece of gauze or similar over the stoma instead.

I hope this helps. Good luck with your decision.
I have had an ileostomy for 31 years now due to UC.
Moderator of the Ostomy Forum
I'm not a complete idiot - some parts of me are missing!

Veteran Member

Date Joined Aug 2007
Total Posts : 1998
   Posted 9/13/2007 2:32 PM (GMT -6)   
Great explanation Shaz!
Diagnosed with CD in 1979, many resections and meds
Perm Ileostomy July 1984 at Cleveland Clinic
Disease free since surgery 

Glad Bag
Veteran Member

Date Joined Mar 2007
Total Posts : 699
   Posted 9/14/2007 7:55 PM (GMT -6)   
i want one of those....you mean some people don't have to wear a pouch?

i find that amazing....

however, i am prob not a candidate for that anyway...since my colon, rectum and everything down there are totally ulcerated and fistula'ed out....

i would just need them to take it all out and would prob just keep my ileostomy....

just commenting...talk to you guys soon...I'm off to my poker game..
"All we need is love....love is all we need"

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